Provider Demographics
NPI:1598709867
Name:OBEREMOK, STEVE SLAVA (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:SLAVA
Last Name:OBEREMOK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:720 E LATHAM AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4371
Mailing Address - Country:US
Mailing Address - Phone:951-658-9461
Mailing Address - Fax:951-652-7103
Practice Address - Street 1:720 E LATHAM AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4371
Practice Address - Country:US
Practice Address - Phone:951-658-9461
Practice Address - Fax:951-652-7103
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA86584207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
95 3620366OtherTAX ID
CAOOA865840Medicaid
95 3620366OtherTAX ID
I00673Medicare UPIN